Unconscious patients are tricky. How can you quickly find the cause of their altered mental status? What key aspects should you address in your initial assessment?

This lecture offers a structured and evidence-based framework for assessing an unconscious patient. It covers topics such as: how AEIOU-TIPS can be bad, how to administer antidotes and how to rapidly find preliminary diagnosis in the resus room.

Thank you to GULD and:
- Niklas Jonsson & Samuel Bruchfeld (recording)
- Björn Kolsrud & Anna Eriksson (inspiration)
- Music: Chris Zabriskie - Air Hockey Saloon http://freemusicarchive.org/music/Chr...
- Bondi Beach:    • Anaphylactic Shock Caught On Camera! ...  
- Comic: SMBC: http://www.smbc-comics.com/comic/fals...
- Thumbnail picture: DLR Ritter http://www.freeimages.com/photographe...

Key references:

[METABOLIC vs STRUCTURAL]
- Forsberg et al. Metabolic vs structural coma in the ED--an observational study.
- Forsberg et al. Prognosis in patients presenting with non-
traumatic coma.
- Ikeda et al. Using vital signs to diagnose impaired consciousness: cross sectional observational study

[FLUMAZENILE]
- Pennings et al. Adverse Events Associated with Flumazenil Treatment for the Management of Suspected Benzodiazepine Intoxication – A Systematic Review with Meta-Analyses of Randomised Trials
- Ngo et al. Should a benzodiazepine antagonist be used in unconscious patients presenting to the emergency department?
- Singh et al. Flumazenil and suspected benzodiazepine overdose.
- Haverkos et al. Fatal seizures after flumazenile administration in a patient with mixed overdose.

[GASTRIC LAVAGE]
- Benson et al. Position paper update: gastric lavage for gastrointestinal decontamination.
- Westergaard et al. Adherence to international recommendations for gastric lavage in medical drug poisonings in Denmark 2007-2010.

[OTHER FUN STUFF]
- Yoshino et al. A case of hypoglycemic hemiparesis and literature review.
- Ohshito et al. Hypoglycemia with focal neurological signs as stroke mimic: Clinical and neuroradiological characteristics.
- Luo et al. A Comparison of Commonly Used QT Correction Formulae: The Effect of Heart Rate on the QTc of Normal ECGs.
- Glimåker et al. Early lumbar puncture in adult bacterial meningitis:
rationale for revised guidelines.
- Ninio et al. Variations on the Hermann grid: an extinction illusion.
- Plum and Posner's Diagnosis of Stupor and Coma, 4th Ed.